Shortness of Breath (Dyspnea)

At times, you may have difficulty breathing and feel winded. This is called shortness of breath, or dyspnea. Shortness of breath may be temporary or permanent, depending on the cause.

Causes of Shortness of Breath

Shortness of breath can be caused by many things, such as:

Lung damage from cancer or cancer treatments

Blood clots in your lungs (pulmonary embolism)

Fluid around your heart or lungs

Lung infection (pneumonia)

Asthma or emphysema

Heart damage (congestive heart failure)

Anemia (low number of red blood cells in the body)

The best way to relieve shortness of breath is to treat the cause of it. However, this may not always be possible, so other measures can be taken to help you breathe better. Your doctor and nurse will work with you to determine the best ways to improve your breathing.

Ways to Relieve Shortness of Breath

An immediate way to help relieve shortness of breath is to:

Place a cold washcloth on your forehead

Turn on a fan to increase the air flow in the room

In your daily activities, do only as much activity as you can without becoming uncomfortable. If you feel winded, stop and rest until your breathing returns to how it was when you started. Then, begin again, if you can.

Below are other ways to help relieve the symptoms.

Oxygen

Every cell in your body needs oxygen. If there is a low level of oxygen in your blood, you may feel short of breath. Your doctor or nurse can measure the amount of oxygen in your blood with a small device that is placed on your finger called a pulse oximeter. If your blood does not have enough oxygen, breathing in additional oxygen can help you feel better.

You can get extra oxygen in several ways. One way is with a concentrator, which is a small machine that removes oxygen from the air and delivers it to you through a thin, flexible tube that rests under your nose. Another way is through a prefilled, portable oxygen tank that you can take with you wherever you go. Once the tank runs out of oxygen, it can be refilled. A respiratory or home care company can supply oxygen for you at home, if necessary.

Medication

Your doctor may also prescribe medication for your shortness of breath, depending on the cause of it. You can take these medications by breathing them in, orally (by mouth), or intravenously (through a vein).

If you have asthma, emphysema, or chronic bronchitis, your doctor may prescribe a nebulizer or an inhaler. These are 2 devices that dispense medication as a fine mist through your mouth and into your lungs. Your nurse will teach you how to use the nebulizer or the inhaler.

If there is a blood clot in your lung, your doctor may prescribe a medication to thin your blood (anticoagulant). This medication may be a pill or an injection. Your doctor will prescribe tests and explain the precautions that you must take when you are on these medications.

If you have pneumonia, your doctor may prescribe antibiotics to treat it.

If there is too much fluid around your heart or in your lungs, your doctor may prescribe medications such as water pills or injections to get rid of the fluid.

Other medications that can help improve breathing include:

Corticosteroids such as prednisone (Deltasone®) or methylprednisolone (Medrol®)

Pain medications such as morphine sulfate (Avinza® or Kadian®)

Anti-anxiety medications such as lorazepam (Ativan®) or alprazolam (Xanax®)

Breathing Exercises

Your nurse can show you how to take deep, slow breaths to help relieve your shortness of breath. You can do this using your diaphragm, which is the muscle that separates your chest and abdominal cavity (see figure). This type of breathing is called diaphragmatic breathing.

Try to relax while doing your breathing exercises. Release any tension in your muscles. This can allow your abdomen, ribs, and lungs to expand.

Here are some other breathing exercises to help relieve your shortness of breath.

Deep breathing 4-8-8

This is an exercise that improves air movement in and out of your lungs. This helps to increase the amount of oxygen in your whole body.

Breathe in through your nose for 4 counts

Hold your breath for 8 counts.

Breathe out through pursed lips (like when you are whistling) for 8 counts.

Repeat 4 times.

Chest wall stretch

This exercise improves the flexibility of the muscles in your chest wall.

Breathe in through your nose for 4 counts. As you are breathing in, raise your arms straight over your head.

Breathe out through pursed lips. As you are breathing out, turn your palms away from you and lower your arms down to your sides.

Repeat 4 times.

Quick sniffles

This exercise can help strengthen your diaphragm.

Close your mouth.

Breathe in and out of your nose quickly, for 15 to 30 seconds.

Try to do this exercise several times, until you reach 60 seconds.

Walking and breathing

These tips will help you breathe easier while you are walking

While walking on a flat surface, keep your mouth closed and breathe in and out of your nose.

While walking on an incline (hill), breathe in through your nose and breathe out through pursed lips.

While climbing stairs, breathe out through pursed lips with each step.

Recovering from an episode of shortness of breath (from coughing or physical activity)

Tilt your chin down to your chest.

Breathe out through your lips in short bursts 10 times.

When your neck muscles feel less stressed, breathe in through your nose.

Breathe out through pursed lips 3 times.

Breathe in through your nose for 4 counts.

Breathe out through an open mouth making an “ah” sound for 8 counts.

Repeat 3 times.

Other Ways to Improve Breathing

Acupuncture and acupressure can help some people feel less short of breath. Your nurse can refer you to our Integrative Medicine Service for these treatments. If you are on medication or oxygen, you will need to keep taking them in addition to having acupuncture. Do not stop taking any prescribed medication without speaking to your doctor first.

Managing Anxiety

Shortness of breath can be scary and some people say they start to feel anxious when they are short of breath. However, anxiety can cause your breathing to become even more difficult.

Although the breathing exercises in this resource can help you relax, you may want to learn additional ways to help you manage your anxiety. Speak with your doctor, nurse, or social worker about any anxiety you are having. The Integrative Medicine Service at MSKCC also offers relaxation programs that may be helpful for you.

Call Your Doctor or Nurse If You Have:

Shortness of breath that is not relieved by using extra oxygen, taking breathing medications, or doing breathing exercises